Knowledge of the etiological and pathogenetic mechanisms of the development of any disease is essential for its treatment.Because the cause of primary biliary cholangitis(PBC),a chronic,slowly progressive cholestatic ...Knowledge of the etiological and pathogenetic mechanisms of the development of any disease is essential for its treatment.Because the cause of primary biliary cholangitis(PBC),a chronic,slowly progressive cholestatic liver disease,is still unknown,treatment remains symptomatic.Knowledge of the physicochemical properties of various bile acids and the adaptive responses of cholangiocytes and hepatocytes to them has provided an important basis for the development of relatively effective drugs based on hydrophilic bile acids that can potentially slow the progression of the disease.Advances in the use of hydrophilic bile acids for the treatment of PBC are also associated with the discovery of pathogenetic mechanisms of the development of cholangiocyte damage and the appearance of the first signs of this disease.For 35 years,ursodeoxycholic acid(UDCA)has been the unique drug of choice for the treatment of patients with PBC.In recent years,the list of hydrophilic bile acids used to treat cholestatic liver diseases,including PBC,has expanded.In addition to UDCA,the use of obeticholic acid,tauroursodeoxycholic acid and norursodeoxycholic acid as drugs is discussed.The pathogenetic rationale for treatment of PBC with various bile acid drugs is discussed in this review.Emphasis is made on the mechanisms explaining the beneficial therapeutic effects and potential of each of the bile acid as a drug,based on the understanding of the pathogenesis of the initial stages of PBC.展开更多
BACKGROUND The incidence of malignant gastrointestinal(GI)tumors is increasing,and advancements in medical care have significantly improved patient survival rates.As a result,the number of cases involving multiple pri...BACKGROUND The incidence of malignant gastrointestinal(GI)tumors is increasing,and advancements in medical care have significantly improved patient survival rates.As a result,the number of cases involving multiple primary cancers(MPC)has also increased.The rarity of MPC and the absence of sensitive and specific dia-gnostic markers often lead to missed or incorrect diagnoses.It is,therefore,of vital importance to improve the vigilance of clinicians and the accurate diagnosis of this disease.Patients with GI malignancies face a higher relative risk of deve-loping additional primary malignant tumors compared to those with other systemic tumors.Vigilant monitoring and follow-up are crucial,especially for high-risk groups,which include older adults,men,those with addictions to alcohol and tobacco,those with a family history of tumors,and those who have undergone radiotherapy.CASE SUMMARY In this article,we report three cases of MPC,each involving malignant tumors of the GI tract as the initial primary carcinoma,offering insights that may aid in effectively managing similar cases.CONCLUSION Patients with GI malignancies face a higher MPC risk.Developing screening and follow-up protocols may enhance detection and treatment outcomes.展开更多
BACKGROUND Primary biliary cholangitis(PBC)is a chronic autoimmune-mediated cholestatic liver disease.Nanoparticles encapsulating rapamycin(ImmTOR)suppress adaptive immune responses and induce the hepatic tolerogenic ...BACKGROUND Primary biliary cholangitis(PBC)is a chronic autoimmune-mediated cholestatic liver disease.Nanoparticles encapsulating rapamycin(ImmTOR)suppress adaptive immune responses and induce the hepatic tolerogenic immune response.AIM To investigate the effects of ImmTOR in PBC mouse models.METHODS PBC models were induced in C57BL/6 mice by two immunizations of 2-octynoic acid-coupled bovine serum albumin at two-week intervals,and polycytidylic acid every three days.The PBC mouse models were separated into the treatment group and the control group.The levels of alkaline phosphatase(ALP)and alanine aminotransferase in the mice were detected using an automatic biochemical analyzer.Liver and spleen mononuclear cells were analyzed by flow cytometry,and serum anti-mitochondrial antibodies(AMA)and the related cytokines were analyzed by enzyme-linked immunosorbent assay.Liver histopathology was examined by hematoxylin and eosin staining and scored.RESULTS After treatment with ImmTOR,the ALP level was significantly decreased(189.60 U/L±27.25 U/L vs 156.00 U/L±17.21 U/L,P<0.05),the level of AMA was reduced(1.28 ng/mL±0.27 ng/mL vs 0.56 ng/mL±0.07 ng/mL,P<0.001)and the expression levels of interferon gamma and tumor necrosis factorαwere significantly decreased(48.29 pg/mL±10.84 pg/mL vs 25.01 pg/mL±1.49 pg/mL,P<0.0001)and(84.24 pg/mL±23.47 pg/mL vs 40.66 pg/mL±14.65 pg/mL,P<0.001).The CD4+T lymphocytes,CD8+T lymphocytes and B lymphocytes in the liver were significantly reduced,with statistically significant differences(24.21%±6.55%vs 15.98%±3.03%,P<0.05;9.09%±1.91%vs 5.49%±1.00%,P<0.001;80.51%±2.96%vs 75.31%±4.34%,P<0.05).The expression of CD8+T lymphocytes and B lymphocytes in the ImmTOR treatment group also decreased(9.09%±1.91%vs 5.49%±1.00%,P<0.001;80.51%±2.96%vs 75.31%±4.34%,P<0.05).The liver pathology of PBC mice in the treatment group showed reduced inflammation and a decreased total pathology score,and the difference in the scores was statistically significant(4.50±2.88 vs 1.75±1.28,P<0.05).CONCLUSION ImmTOR can improve biochemistry and pathology of liver obvious by inhibiting the expression of CD8+T cells and B cells,and reducing the titer of AMA.展开更多
Primary ciliary dyskinesia(PCD)is a clinically rare,genetically and phenotypically heterogeneous condition characterized by chronic respiratory tract infections,male infertility,tympanitis,and laterality abnormalities...Primary ciliary dyskinesia(PCD)is a clinically rare,genetically and phenotypically heterogeneous condition characterized by chronic respiratory tract infections,male infertility,tympanitis,and laterality abnormalities.PCD is typically resulted from variants in genes encoding assembly or structural proteins that are indispensable for the movement of motile cilia.Here,we identified a novel nonsense mutation,c.466G>T,in cilia-and flagella-associated protein 300(CFAP300)resulting in a stop codon(p.Glu156*)through whole-exome sequencing(WES).The proband had a PCD phenotype with laterality defects and immotile sperm flagella displaying a combined loss of the inner dynein arm(IDA)and outer dynein arm(ODA).Bioinformatic programs predicted that the mutation is deleterious.Successful pregnancy was achieved through intracytoplasmic sperm injection(ICSI).Our results expand the spectrum of CFAP300 variants in PCD and provide reproductive guidance for infertile couples suffering from PCD caused by them.展开更多
BACKGROUND Colorectal cancer(CRC)ranks high among the most common types of malignant tumors.The primary cause of cancer-related mortality is metastasis,with lung metastases accounting for 32.9%of all cases of metastat...BACKGROUND Colorectal cancer(CRC)ranks high among the most common types of malignant tumors.The primary cause of cancer-related mortality is metastasis,with lung metastases accounting for 32.9%of all cases of metastatic CRC(MCRC).However,cases of MCRC in the lungs,which present concurrently with primary peripheral lung adenocarcinoma,are exceptionally rare.CASE SUMMARY This report describes the case of a 52-year-old female patient who,following a colonoscopy,was diagnosed with moderately differentiated adenocarcinoma based on rectal mucosal biopsy findings.A preoperative chest computed tomography scan revealed a ground-glass nodule in the right lung and a small nodule(approximately 0.6 cm in diameter)in the extramural basal segment of the left lower lobe,which suggested multiple lung metastases from rectal cancer.Subsequent treatment and follow-up led to a diagnosis of rectal cancer with left lung metastasis and peripheral adenocarcinoma of the lower lobe of the right lung.CONCLUSION This case report describes the therapeutic journey of a patient with lung metastasis from rectal cancer in addition to primary peripheral adenocarcinoma,thus underscoring the critical roles of multidisciplinary collaboration,personalized treatment strategies,and comprehensive patient rehabilitation guidance.展开更多
Background: Primary pulmonary lymphoepithelioma-like carcinoma (LELC) is a rare subtype of non-small cell lung cancer (NSCLC). Nevertheless, no universally acknowledged standards of care have been reported to be effec...Background: Primary pulmonary lymphoepithelioma-like carcinoma (LELC) is a rare subtype of non-small cell lung cancer (NSCLC). Nevertheless, no universally acknowledged standards of care have been reported to be effective and productive for the treatment of this tumor. Materials and Methods: A patient with advanced primary pulmonary LELC was treated by employing a combination of tislelizumab and chemotherapy. Results: The patient displayed a favorable response to the combination therapy. The tumor size exhibited conspicuous abatement in contrast to the pre-treatment baseline, and the tumor markers normalized. Conclusion: The combination of immunotherapy with chemotherapy appears to be more effective than therapy alone for managing advanced primary pulmonary LELC. On that account, further clinical trials are imperative to establish this combination regimen as a potential first-line treatment option for advanced cases.展开更多
Parental educational anxiety has become a social symptom in China,and rural primary school students’mothers exhibit unique educational anxieties due to their special living environment.Based on interviews with 10 rur...Parental educational anxiety has become a social symptom in China,and rural primary school students’mothers exhibit unique educational anxieties due to their special living environment.Based on interviews with 10 rural primary school students’mothers,five typical educational anxiety experiences were selected for analysis,and themes such as rural life burden,children’s learning habits,mothers’educational expectations,mothers’educational methods,mothers’emotional state,deviation between reality and expectations,homework guidance ability,mothers’educational level,and attitudes towards children’s future development were refined.The root causes of educational anxiety among rural primary school students’mothers include the deviation between children’s actual performance and mothers’educational expectations,the sense of disparity under social comparison,physical and mental exhaustion caused by role overload,anxiety triggered by excessive economic burden,and a sense of powerlessness towards children’s educational outcomes.To alleviate the educational anxiety of rural primary school students’mothers,mothers should actively adjust themselves,fathers should actively participate in their children’s education,society should create a healthy atmosphere,and schools should strengthen family education guidance.展开更多
AIM:To investigate decisional conflict among patients diagnosed with primary angle-closure suspect(PACS)or primary angle-closure(PAC)who are considering laser peripheral iridotomy(LPI)treatment.METHODS:A total of 111 ...AIM:To investigate decisional conflict among patients diagnosed with primary angle-closure suspect(PACS)or primary angle-closure(PAC)who are considering laser peripheral iridotomy(LPI)treatment.METHODS:A total of 111 individuals diagnosed with PACS or PAC were selected through convenient sampling from March 2023 to December 2023.These participants then completed a general information questionnaire and the Decision Conflict Scale.Data analysis was performed using multiple linear regression to reveal factors influencing decisional conflict.RESULTS:The mean Decisional Conflict Score among patients with PACS or PAC was 48.58±10.01,with 99.1%of these individuals reporting experiencing decisional conflict.Multiple linear regression analysis revealed that females(P=0.002)and patients with a shorter duration of the disease(P=0.006)had higher levels of decisional conflict.Additionally,patients diagnosed during medical visits(P=0.049),those who refused LPI treatment(P=0.032),and individuals facing significant economic burdens related to medical expenses(P=0.005)exhibited higher levels of decisional conflict.Furthermore,patients who preferred to make medical decisions independently(P=0.023)and those who favored involving family members in decisionmaking(P=0.005)experienced increased levels of decisional conflict.CONCLUSION:Patients with PACS or PAC who undergo LPI treatment often encounter significant decisional conflict.Healthcare professionals should thoroughly assess a range of factors that influence this conflict,including gender,duration of disease,method of diagnosis acquisition,LPI treatment,economic burden of medical expenses,and patient preferences regarding medical decision-making.By considering these variables,tailored decision support can be developed to address individual patient needs,ultimately reducing decisional conflict and optimizing the quality of decisions made regarding treatment options.展开更多
Silicon-based anodes,utilizing nanosized silicon materials,hold great promise for the next-generation of lithium-ion batteries due to their high capacity and stable expansion.This study aims to address challenges in t...Silicon-based anodes,utilizing nanosized silicon materials,hold great promise for the next-generation of lithium-ion batteries due to their high capacity and stable expansion.This study aims to address challenges in traditional slurry-coated anodes,such as agglomeration and low adhesive strength,through the application of laser powder bed fusion(LPBF).The process involves fabricating an Al-Si-Cu alloy layer on a Cu foil current collector,followed by dealloying to create a porous Si-Cu anode.Simulated and experimental results demonstrate successful alloy layer formation through optimized laser spot(55μm)and powder sizes(1-5μm).Controlled cooling produces primary Si particles ranging from 150 nm to 1μm.The resulting microstructure enhances electrochemical performance,particularly by tailoring the size of primary Si.The resultant porous Si-Cu anode,featuring uniformly distributed primary Si(200 nm)metallurgically bonded with Cu networks,exhibits an initial coulombic efficiency of 83% and a remarkable capacity retention of 80% after 300 cycles at 2 C.In-situ and ex-situ observations confirm the crucial role of anode architecture in performance enhancement.This study elucidates the influence of the LPBF microstructure on anode performance and broadens the potential application of laser powder bed fusion in battery manufacturing.展开更多
Li/MnO_(2) primary batteries are widely used in industry for their high specific capacity and safety.However,a deep comprehension of the Li^(+)insertion mechanism and the high self-discharge rate of the batteries is s...Li/MnO_(2) primary batteries are widely used in industry for their high specific capacity and safety.However,a deep comprehension of the Li^(+)insertion mechanism and the high self-discharge rate of the batteries is still needed.Here,the storage mechanism of Li^(+)in the tunnel structure of MnO_(2) as well as the dissolution and migration of Mn-ions were investigated based on multi-scale approaches.The Li/Mn ratio(at%)is determined at about 0.82 when the discharge voltage decreases to 2 V.The limited Li-ions transport rate in the bulk MnO_(2) restrains the reduction reaction,resulting in a low practical specific capacity.Moreover,utilizing spherical aberration-corrected transmission electron microscopy(TEM)coupled with electron energy loss spectroscopy(EELS),the presence of a mixed valence state layer of Mn^(2+)/Mn^(3+)/Mn^(4+)on the surface of the original 20 nm MnO_(2) particles was identified,which could contribute to the initial dissolution of Mn-ions.The battery separator exhibited channels for Mn-ions migration and diffusion and aggregated Mn particles.We put forward the discharge and degradation route in the ways of Mn-ions trajectories,and our findings provide a deep understanding of the high self-discharge rates and the capacity decay of Li-Mn primary batteries.展开更多
BACKGROUND Glaucoma,a condition frequently linked to severe depression,anxiety,and sleep disturbances,affects treatment adherence while potentially compromising effectiveness.AIM To explore illness uncertainty(IU),anx...BACKGROUND Glaucoma,a condition frequently linked to severe depression,anxiety,and sleep disturbances,affects treatment adherence while potentially compromising effectiveness.AIM To explore illness uncertainty(IU),anxiety,and depressive symptoms in primary glaucoma and to discuss underlying triggers.METHODS We recruited 120 primary glaucoma cases between January 2022 and November 2023.The Mishel Uncertainty in Illness Scale(MUIS)and the Hospital Anxiety and Depression Scale(HADS)[include HADS-anxiety subscale(HADS-A)and HADS-depression subscale(HADS-D)]subscales,were used to assess IU and emotional distress(anxiety/depression),respectively.The MUIS-HADS subscale interrelationships were determined by Pearson correlation.IU-associated determinants were identified using univariate and binary logistic regression analyses.RESULTS The cohort showed a mean MUIS score of 79.73±8.97,corresponding to a moderately high IU level.The HADS-A and HADS-D scores averaged 6.57±3.89 and 7.08±5.05 points,respectively,with 15.00%of participants showing anxiety symptoms and 24.17%exhibiting depressive signs.Significant positive connections were observed between MUIS and both HADS-A(r=0.359,P<0.001)and HADSD(r=0.426,P<0.001).Univariate analysis revealed that disease duration,insomnia,monthly household income per capita,and the presence of comorbid chronic conditions were significantly associated with anxiety or depression.Multivariate analysis identified insomnia as a risk factor and higher monthly household income as a protective factor.CONCLUSION Patients with primary glaucoma experience moderate IU levels,generally low anxiety,and mild depression.Specifically,the anxiety and depression risks were 15.00%and 24.17%,respectively.A significant positive correlation existed between IU and anxiety/depression in these patients.Additionally,insomnia or lower monthly household income elevated anxiety/depression risks,enabling reliable anxiety/depression risk categorization among patients.展开更多
In China's healthcare system,primary healthcare services are crucial and bear the responsibility of safeguarding public health.However,at present,primary healthcare is facing many challenges,such as the scarcity o...In China's healthcare system,primary healthcare services are crucial and bear the responsibility of safeguarding public health.However,at present,primary healthcare is facing many challenges,such as the scarcity of advanced medical equipment and insufficient provision of common basic examination instruments,which limits diagnosis.At the same time,a large number of professional talents have been lost,and the service level is difficult to meet the needs of the public.The public's trust in primary healthcare has decreased,exacerbating the mismatch of medical resources.The development of information technology has brought about telemedicine,which has become a key breakthrough.It uses Internet and other technologies to break regional restrictions,so that grass-roots patients can easily access expert diagnosis and treatment,and also provides a learning platform for grass-roots medical personnel.Thoroughly studying its application strategies is of great significance for improving the level of primary healthcare and promoting medical equity.展开更多
Objective:Advanced gastric cancer remains highly refractory to therapy,with limited immunotherapy efficacy due to tumor microenvironment heterogeneity.Primary cilia,microtubule-based organelles involved in tumor progr...Objective:Advanced gastric cancer remains highly refractory to therapy,with limited immunotherapy efficacy due to tumor microenvironment heterogeneity.Primary cilia,microtubule-based organelles involved in tumor progression,remain insufficiently explored in gastric cancer.This study aimed to define primary cilia subtypes and establish prognostic signatures for personalized treatment strategies.Methods:Bulk transcriptomic data from over 1,500 gastric cancer samples were integrated to define distinct primary cilia subtypes.A primary ciliary phenotype-associated signature(PCS)was established using a multimachine learning survival framework incorporating ten algorithms.The prognostic predictive value and immunotherapy response prediction capability of PCS were validated across multiple independent cohorts.Singlecell RNA sequencing analysis was performed to identify cellular populations associated with high-PCS phenotype.Causal weighted gene co-expression network analysis(WGCNA)was employed to identify driving factors,followed by functional validation through cell culture experiments and xenograft models.Results:Two distinct primary cilia subtypes were identified and validated across all cohorts,with C2 patients exhibiting significantly worse overall survival compared to C1 patients.PCS demonstrated robust predictive value for both prognosis and immunotherapy response,with superior accuracy compared to existing models across multiple validation cohorts.High-PCS patients showed reduced tumor purity,increased stromal cell infiltration,and poor response to immunotherapy.Single-cell analysis revealed that fibroblasts had the highest PCS scores and identified a novel secreted modular calcium-binding protein 2(SMOC2)^(high)myofibroblastic cancer-associated fibroblast(mCAF)population as the key driver of high-PCS phenotype.Functional experiments confirmed that SMOC2 knockdown significantly suppressed gastric cancer cell proliferation,migration,and invasion,while promoting mCAF-to-inflammatory cancer-associated fibroblasts(iCAF)transition.Conclusions:PCS serves as a robust prognostic biomarker for gastric cancer patients.Additionally,targeting SMOC2^(high)mCAFs represents a potential therapeutic strategy for patients with high-PCS gastric cancer.展开更多
Enhancing the carbon sink of terrestrial ecosystems is an essential nature-based solution to mitigate global warming and achieve the target of carbon neutrality.Over recent decades,China has launched a series of long-...Enhancing the carbon sink of terrestrial ecosystems is an essential nature-based solution to mitigate global warming and achieve the target of carbon neutrality.Over recent decades,China has launched a series of long-running and large-scale ambitious forestation projects.However,there is still a lack of year-to-year evaluation on the effects of afforestation on carbon sequestration.Satellite remote sensing provides continuous observations of vegetation dynamics and land use and land cover change,is becoming a practical tool to evaluate the changes of vegetation productivity driven by afforestation.Here,a spatially-explicit analysis was conducted by combining Moderate Resolution Imaging Spectroradiometer(MODIS)land cover and three up-to-date remote sensing gross primary productivity(GPP)datasets of China.The results showed that the generated afforestation maps have similar spatial distribution with the national forest inventory data at the provincial level.The accumulative areas of afforestation were 3.02×10^(5)km^(2)in China from 2002 to 2018,it was mainly distributed in Southwest(SW),South(Sou),Southeast(SE)and Northeast(NE)of China.Among them,SW possesses the largest afforestation sub-region,with an area of 9.38×10^(4)km^(2),accounting for 31.06%of the total.There were divergent trends of affores-tation area among different sub-regions.The southern sub-regions showed increasing trends,while the northern sub-regions showed decreasing trends.In keeping with these,the center of annual afforestation moved to the south after 2009.The southern sub-regions were the majority of the cumula-tive GPP,accounting for nearly 70%of the total.The GPP of new afforestation showed an increasing trend from 2002 to 2018,and the increasing rate was higher than existing forests.After afforestation,the GPP change of afforestation was higher than adjacent non-forest over the same period.Our work provides new evidence that afforestation of China has enhanced the carbon assimilation and will deepen our understanding of dynamics of carbon sequestration driven by afforestation.展开更多
BACKGROUND Primary cardiac lymphoma(PCL)is a rare subset of cardiac tumors,often diagnosed late due to nonspecific symptoms.It predominantly affects immunocompromised individuals,primarily in the pericardium and right...BACKGROUND Primary cardiac lymphoma(PCL)is a rare subset of cardiac tumors,often diagnosed late due to nonspecific symptoms.It predominantly affects immunocompromised individuals,primarily in the pericardium and right heart.Late diagnosis mimics common cardiac ailments,leading to poor prognosis.AIM To systematically review the efficacy of rituximab in treating PCL either alone or in various chemotherapeutic regimens.Secondary objectives include evaluating morphological subtypes,assessing treatment regimens,and analyzing outcomes focusing on remission and adverse events.METHODS Following PRISMA guidelines,a comprehensive literature search was conducted across multiple databases,including PubMed,Hinari,Web of Science,and Scopus.English-language studies reporting the use of rituximab in treating PCL in humans were included.Study selection involved initial screening of titles and abstracts followed by full-text examination and data extraction.RESULTS Thirty-three case reports involving 36 patients were included in this systematic review.Diffuse large B-cell lymphoma was the predominant morphological subtype observed.The rituximab,cyclophosphamide,doxorubicin,oncovin,and prednisolone regimen emerged as the most commonly employed treatment strategy,indicating widespread acceptance and efficacy in PCL management.Combination therapies,including surgical intervention,showed promise in achieving complete remission,while some studies reported mortality despite aggressive treatment approaches.CONCLUSION Rituximab,particularly in combination with chemotherapy regimens,represents a significant advancement in PCL management,offering hope for improved patient outcomes.However,challenges such as variable treatment responses and adverse events underscore the complexity of managing PCL.Further research is warranted to refine therapeutic strategies and enhance diagnostic approaches for this rare cardiac malignancy.展开更多
BACKGROUND Ursodeoxycholic acid(UDCA)is the first-line therapeutic agent for primary biliary cholangitis(PBC).However,a subset of patients exhibit a suboptimal response to UDCA,and reliable predictive biomarkers remai...BACKGROUND Ursodeoxycholic acid(UDCA)is the first-line therapeutic agent for primary biliary cholangitis(PBC).However,a subset of patients exhibit a suboptimal response to UDCA,and reliable predictive biomarkers remain elusive.Studies have implicated plasma microRNAs(miRNAs)in the pathophysiological pro-gression of PBC,with certain miRNAs demonstrating potential as diagnostic and disease progression biomarkers.However,biomarkers capable of predicting the therapeutic efficacy of UDCA have not yet been identified.AIM To investigate differentially expressed miRNAs in PBC patients with divergent UDCA treatment responses and to explore potential biomarkers that predict treatment response in PBC.METHODS Plasma samples from treatment-naive PBC patients receiving≥1 year of standard UDCA treatment were collected.Efficacy was evaluated using the Paris I criteria.Patient samples were divided into discovery group(n=10)and validation group(n=30),with further stratification of patients into drug-resistant and drug-sensitive(DS)cohorts.Next-generation sequencing and quantitative real-time polymerase chain reaction were used to screen,functionally analyze,and validate the pre-treatment miRNA profiles of the treatment groups.RESULTS Forty-nine miRNAs were differentially expressed between the two groups before UDCA treatment(N=40).MiR-22-5p and miR-126-3p were highly expressed in the DS group before treatment(P<0.001),whereas miR-7706 exhibited a low expression(P=0.017).Post-treatment,miR-126-3p maintained low expression in the drug-resistant group(P=0.003),but showed elevated levels in the DS group(P<0.001).Logistic regression analysis identified miR-126-3p expression(odds ratio=34.32,95%confidence interval:1.95-605.40,P=0.016)as a significant factor influencing UDCA treatment response,while miR-22-5p(P=0.990)and miR-7706(P=0.157)showed no significant association.MiR-126-3p levels were negatively correlated with total bilirubin(r=-0.356,P=0.005)and immuno-globulin G levels(r=-0.311,P=0.015).The area under the receiver operating characteristic curve was 0.891(P=0.0003,95%confidence interval:0.772-1.000)with a sensitivity of 82.4%and a specificity of 84.6%.CONCLUSION Plasma miRNA expression profiles are heterogenous in patients with PBC with differential responses to UDCA therapy.MiR-126-3p demonstrates predictive potential for a suboptimal response to UDCA in patients with PBC.展开更多
Casein kinase 1(CK1)is an important member of the serine/threonine protein kinase family,playing a crucial role in various cellular processes,including cell cycle regulation,signal transduction,DNA repair,and circadia...Casein kinase 1(CK1)is an important member of the serine/threonine protein kinase family,playing a crucial role in various cellular processes,including cell cycle regulation,signal transduction,DNA repair,and circadian rhythm control.CK1 is also essential in the nervous system,where it regulates neuronal growth,differentiation,and synaptic plasticity.Studies have shown that CK1δ phosphorylates neuron-specific proteins to regulate axonal growth and synaptogenesis.Primary cilia are non-motile microtubule structures present on the surface of most mammalian cells.Recent studies have revealed their multiple roles in cellular physiology and development,and dysfunction of cilia can impact the development and function of the nervous system.CK1 has an important role in the formation and function of primary cilia.By regulating various signaling pathways and the phosphorylation status of proteins,CK1 affects the generation,maintenance,and signaling transduction of cilia.In this review,the relationship between CK1,primary cilia,and the nervous system was explored,focusing on how CK1 influences cilia to regulate the structure and function of the nervous system.展开更多
Objective:To investigate the lifestyle and myopia among primary school students in urban areas of Fujian with the context of myopia prevention and control measures,aiming to provide scientific evidence for identifying...Objective:To investigate the lifestyle and myopia among primary school students in urban areas of Fujian with the context of myopia prevention and control measures,aiming to provide scientific evidence for identifying high-risk myopia population and formulating effective intervention strategies.Methods:A cross-sectional study was conducted from October to November 2023,enrolling 811 fourth-grade students from three primary schools in three cities across Fujian.Personal information and lifestyle-related pattern were collected using customized questionnaire.Participants underwent comprehensive ophthalmic assessments including distance visual acuity tests and refractive examinations.Logistic regression analysis was used to assess the impact of lifestyle on the onset of myopia.Results:The prevalence of myopia among fourth-grade students in urban primary schools in Fujian was 46.4%.Only 25.8%students engaged in outdoor activities for more than 2 hours daily,while63.3%participated in outdoor activities during class breaks.Multivariate Logistic regression analysis revealed that outdoor activities during class breaks(OR=0.646(95%confidence interval(CI):0.473-0.881),P=0.006)and daily time spent outdoors(2-3 hours,OR=0.682(95%CI:0.466-0.993),P=0.047;more than 3 hours,OR=0.403(95%CI:0.192-0.796),P=0.01)were independent protective factors against myopia.Lifestyle significantly enhanced the predictive performance for myopia(P=0.01).Additionally,parental myopia(one parent with myopia,OR=2.247(95%CI:1.612-3.145),P<0.001;both parents with myopia,OR=4.824(95%CI:3.262-7.204),P<0.001)emerged as a key risk factor for myopia.Conclusions:There is considerable scope for improving the lifestyle of primary school students in urban areas of Fujian.Lifestyle is strongly associated with myopia onset,highlighting the need for schools and families to actively encourage students to engage in more outdoor activities and take breaks outdoors to prevent and control myopia.Students with parents,especially both parents,having myopia should be considered as a key target group for myopia prevention efforts.展开更多
AIM:To compare surgical efficacy based on residual peripheral anterior synechiae(PAS)extent af ter viscogonioplasty(VGP)combined with phacoemulsification and intraocular lens implantation(PEI)in patients with primary ...AIM:To compare surgical efficacy based on residual peripheral anterior synechiae(PAS)extent af ter viscogonioplasty(VGP)combined with phacoemulsification and intraocular lens implantation(PEI)in patients with primary angle-closure disease(PACD)and identify risk factors for extensive postoperative PAS.METHODS:This prospective cohort study included 73 eyes of 61 patients with PACD undergoing PEI with VGP.Patients were divided into Group A(PAS<90°,n=39)and Group B(90°≤PAS≤180°,n=34)based on PAS extent at the end of surgery.PAS progression rates were assessed using a linear mixed-effects model.Logistic regression analyzed risk factors for PAS≥180°at 12mo postoperatively.RESULTS:Both groups showed significant PAS progression at 12mo(P<0.001).Group A had smaller PAS extent than Group B at all time points(P<0.001).PAS progression rates were similar between groups(P=0.335).No significant differences were found in intraocular pressure(IOP),IOP-lowering medications,or surgical success rates(P>0.05).Female[odds ratio(OR)=0.211,P=0.046],preoperative medication number(OR=1.017,P=0.029),and PAS extent at the end of surgery(OR=1.017,P=0.018)were risk factors for PAS≥180°at 12mo.CONCLUSION:Residual PAS extent at the end of surgery predicts postoperative extensive PAS formation but has limited effect on PAS progression rate and IOP control.Female,multiple preoperative IOP-lowering medications,and larger residual PAS extent are independent risk factors for extensive PAS at 12mo postoperatively.展开更多
Primary biliary cholangitis(PBC)is a chronic cholestatic liver disease characterized by damage and loss of the epithelial lining of small intrahepatic bile ducts,leading to ductopenia and cholestasis.In advanced stage...Primary biliary cholangitis(PBC)is a chronic cholestatic liver disease characterized by damage and loss of the epithelial lining of small intrahepatic bile ducts,leading to ductopenia and cholestasis.In advanced stages,this process results in cirrhosis and liver failure.The disease belongs to cholangiopathies.The review addressed historical questions concerning:The history of the first mention of this disease;how its nomenclature was formed;when specific serological tests were discovered and their importance in the diagnosis of PBC;the history of ursodeoxycholic and other bile acids for the treatment of PBC;and the significance of modern data on impaired bicarbonate production by cholangiocytes in the pathogenesis of PBC.展开更多
文摘Knowledge of the etiological and pathogenetic mechanisms of the development of any disease is essential for its treatment.Because the cause of primary biliary cholangitis(PBC),a chronic,slowly progressive cholestatic liver disease,is still unknown,treatment remains symptomatic.Knowledge of the physicochemical properties of various bile acids and the adaptive responses of cholangiocytes and hepatocytes to them has provided an important basis for the development of relatively effective drugs based on hydrophilic bile acids that can potentially slow the progression of the disease.Advances in the use of hydrophilic bile acids for the treatment of PBC are also associated with the discovery of pathogenetic mechanisms of the development of cholangiocyte damage and the appearance of the first signs of this disease.For 35 years,ursodeoxycholic acid(UDCA)has been the unique drug of choice for the treatment of patients with PBC.In recent years,the list of hydrophilic bile acids used to treat cholestatic liver diseases,including PBC,has expanded.In addition to UDCA,the use of obeticholic acid,tauroursodeoxycholic acid and norursodeoxycholic acid as drugs is discussed.The pathogenetic rationale for treatment of PBC with various bile acid drugs is discussed in this review.Emphasis is made on the mechanisms explaining the beneficial therapeutic effects and potential of each of the bile acid as a drug,based on the understanding of the pathogenesis of the initial stages of PBC.
基金Supported by Gansu Provincial Natural Science Foundation,No.21JR1RA010In-Hospital Research Fund of Gansu Provincial Hospital,No.23GSSYD-5.
文摘BACKGROUND The incidence of malignant gastrointestinal(GI)tumors is increasing,and advancements in medical care have significantly improved patient survival rates.As a result,the number of cases involving multiple primary cancers(MPC)has also increased.The rarity of MPC and the absence of sensitive and specific dia-gnostic markers often lead to missed or incorrect diagnoses.It is,therefore,of vital importance to improve the vigilance of clinicians and the accurate diagnosis of this disease.Patients with GI malignancies face a higher relative risk of deve-loping additional primary malignant tumors compared to those with other systemic tumors.Vigilant monitoring and follow-up are crucial,especially for high-risk groups,which include older adults,men,those with addictions to alcohol and tobacco,those with a family history of tumors,and those who have undergone radiotherapy.CASE SUMMARY In this article,we report three cases of MPC,each involving malignant tumors of the GI tract as the initial primary carcinoma,offering insights that may aid in effectively managing similar cases.CONCLUSION Patients with GI malignancies face a higher MPC risk.Developing screening and follow-up protocols may enhance detection and treatment outcomes.
基金Supported by Cultivation Project of Hebei Natural Science Foundation-Precision Medicine Joint Fund,No.H2021206239.
文摘BACKGROUND Primary biliary cholangitis(PBC)is a chronic autoimmune-mediated cholestatic liver disease.Nanoparticles encapsulating rapamycin(ImmTOR)suppress adaptive immune responses and induce the hepatic tolerogenic immune response.AIM To investigate the effects of ImmTOR in PBC mouse models.METHODS PBC models were induced in C57BL/6 mice by two immunizations of 2-octynoic acid-coupled bovine serum albumin at two-week intervals,and polycytidylic acid every three days.The PBC mouse models were separated into the treatment group and the control group.The levels of alkaline phosphatase(ALP)and alanine aminotransferase in the mice were detected using an automatic biochemical analyzer.Liver and spleen mononuclear cells were analyzed by flow cytometry,and serum anti-mitochondrial antibodies(AMA)and the related cytokines were analyzed by enzyme-linked immunosorbent assay.Liver histopathology was examined by hematoxylin and eosin staining and scored.RESULTS After treatment with ImmTOR,the ALP level was significantly decreased(189.60 U/L±27.25 U/L vs 156.00 U/L±17.21 U/L,P<0.05),the level of AMA was reduced(1.28 ng/mL±0.27 ng/mL vs 0.56 ng/mL±0.07 ng/mL,P<0.001)and the expression levels of interferon gamma and tumor necrosis factorαwere significantly decreased(48.29 pg/mL±10.84 pg/mL vs 25.01 pg/mL±1.49 pg/mL,P<0.0001)and(84.24 pg/mL±23.47 pg/mL vs 40.66 pg/mL±14.65 pg/mL,P<0.001).The CD4+T lymphocytes,CD8+T lymphocytes and B lymphocytes in the liver were significantly reduced,with statistically significant differences(24.21%±6.55%vs 15.98%±3.03%,P<0.05;9.09%±1.91%vs 5.49%±1.00%,P<0.001;80.51%±2.96%vs 75.31%±4.34%,P<0.05).The expression of CD8+T lymphocytes and B lymphocytes in the ImmTOR treatment group also decreased(9.09%±1.91%vs 5.49%±1.00%,P<0.001;80.51%±2.96%vs 75.31%±4.34%,P<0.05).The liver pathology of PBC mice in the treatment group showed reduced inflammation and a decreased total pathology score,and the difference in the scores was statistically significant(4.50±2.88 vs 1.75±1.28,P<0.05).CONCLUSION ImmTOR can improve biochemistry and pathology of liver obvious by inhibiting the expression of CD8+T cells and B cells,and reducing the titer of AMA.
基金supported by the China Postdoctoral Science Foundation Grant(2023M734294)Jiangsu Provincial Medical Key Discipline Cultivation Unit(JSDW202215)the National Natural Science Foundation of China(No.82001618).
文摘Primary ciliary dyskinesia(PCD)is a clinically rare,genetically and phenotypically heterogeneous condition characterized by chronic respiratory tract infections,male infertility,tympanitis,and laterality abnormalities.PCD is typically resulted from variants in genes encoding assembly or structural proteins that are indispensable for the movement of motile cilia.Here,we identified a novel nonsense mutation,c.466G>T,in cilia-and flagella-associated protein 300(CFAP300)resulting in a stop codon(p.Glu156*)through whole-exome sequencing(WES).The proband had a PCD phenotype with laterality defects and immotile sperm flagella displaying a combined loss of the inner dynein arm(IDA)and outer dynein arm(ODA).Bioinformatic programs predicted that the mutation is deleterious.Successful pregnancy was achieved through intracytoplasmic sperm injection(ICSI).Our results expand the spectrum of CFAP300 variants in PCD and provide reproductive guidance for infertile couples suffering from PCD caused by them.
文摘BACKGROUND Colorectal cancer(CRC)ranks high among the most common types of malignant tumors.The primary cause of cancer-related mortality is metastasis,with lung metastases accounting for 32.9%of all cases of metastatic CRC(MCRC).However,cases of MCRC in the lungs,which present concurrently with primary peripheral lung adenocarcinoma,are exceptionally rare.CASE SUMMARY This report describes the case of a 52-year-old female patient who,following a colonoscopy,was diagnosed with moderately differentiated adenocarcinoma based on rectal mucosal biopsy findings.A preoperative chest computed tomography scan revealed a ground-glass nodule in the right lung and a small nodule(approximately 0.6 cm in diameter)in the extramural basal segment of the left lower lobe,which suggested multiple lung metastases from rectal cancer.Subsequent treatment and follow-up led to a diagnosis of rectal cancer with left lung metastasis and peripheral adenocarcinoma of the lower lobe of the right lung.CONCLUSION This case report describes the therapeutic journey of a patient with lung metastasis from rectal cancer in addition to primary peripheral adenocarcinoma,thus underscoring the critical roles of multidisciplinary collaboration,personalized treatment strategies,and comprehensive patient rehabilitation guidance.
文摘Background: Primary pulmonary lymphoepithelioma-like carcinoma (LELC) is a rare subtype of non-small cell lung cancer (NSCLC). Nevertheless, no universally acknowledged standards of care have been reported to be effective and productive for the treatment of this tumor. Materials and Methods: A patient with advanced primary pulmonary LELC was treated by employing a combination of tislelizumab and chemotherapy. Results: The patient displayed a favorable response to the combination therapy. The tumor size exhibited conspicuous abatement in contrast to the pre-treatment baseline, and the tumor markers normalized. Conclusion: The combination of immunotherapy with chemotherapy appears to be more effective than therapy alone for managing advanced primary pulmonary LELC. On that account, further clinical trials are imperative to establish this combination regimen as a potential first-line treatment option for advanced cases.
基金Hunan Provincial Social Science Foundation“A Phenomenological Study on the Educational Life Experiences of Rural Young Teachers”(20YBA017)。
文摘Parental educational anxiety has become a social symptom in China,and rural primary school students’mothers exhibit unique educational anxieties due to their special living environment.Based on interviews with 10 rural primary school students’mothers,five typical educational anxiety experiences were selected for analysis,and themes such as rural life burden,children’s learning habits,mothers’educational expectations,mothers’educational methods,mothers’emotional state,deviation between reality and expectations,homework guidance ability,mothers’educational level,and attitudes towards children’s future development were refined.The root causes of educational anxiety among rural primary school students’mothers include the deviation between children’s actual performance and mothers’educational expectations,the sense of disparity under social comparison,physical and mental exhaustion caused by role overload,anxiety triggered by excessive economic burden,and a sense of powerlessness towards children’s educational outcomes.To alleviate the educational anxiety of rural primary school students’mothers,mothers should actively adjust themselves,fathers should actively participate in their children’s education,society should create a healthy atmosphere,and schools should strengthen family education guidance.
基金Supported by Basic Scientific Research Projects of Wenzhou(No.Y20220155).
文摘AIM:To investigate decisional conflict among patients diagnosed with primary angle-closure suspect(PACS)or primary angle-closure(PAC)who are considering laser peripheral iridotomy(LPI)treatment.METHODS:A total of 111 individuals diagnosed with PACS or PAC were selected through convenient sampling from March 2023 to December 2023.These participants then completed a general information questionnaire and the Decision Conflict Scale.Data analysis was performed using multiple linear regression to reveal factors influencing decisional conflict.RESULTS:The mean Decisional Conflict Score among patients with PACS or PAC was 48.58±10.01,with 99.1%of these individuals reporting experiencing decisional conflict.Multiple linear regression analysis revealed that females(P=0.002)and patients with a shorter duration of the disease(P=0.006)had higher levels of decisional conflict.Additionally,patients diagnosed during medical visits(P=0.049),those who refused LPI treatment(P=0.032),and individuals facing significant economic burdens related to medical expenses(P=0.005)exhibited higher levels of decisional conflict.Furthermore,patients who preferred to make medical decisions independently(P=0.023)and those who favored involving family members in decisionmaking(P=0.005)experienced increased levels of decisional conflict.CONCLUSION:Patients with PACS or PAC who undergo LPI treatment often encounter significant decisional conflict.Healthcare professionals should thoroughly assess a range of factors that influence this conflict,including gender,duration of disease,method of diagnosis acquisition,LPI treatment,economic burden of medical expenses,and patient preferences regarding medical decision-making.By considering these variables,tailored decision support can be developed to address individual patient needs,ultimately reducing decisional conflict and optimizing the quality of decisions made regarding treatment options.
基金financially supported by the National Key Research and Development Program of China(2022YFB4602700)the National Natural Science Foundation of China(No.51975018)the Beijing Natural Science Foundation(No.2244085).
文摘Silicon-based anodes,utilizing nanosized silicon materials,hold great promise for the next-generation of lithium-ion batteries due to their high capacity and stable expansion.This study aims to address challenges in traditional slurry-coated anodes,such as agglomeration and low adhesive strength,through the application of laser powder bed fusion(LPBF).The process involves fabricating an Al-Si-Cu alloy layer on a Cu foil current collector,followed by dealloying to create a porous Si-Cu anode.Simulated and experimental results demonstrate successful alloy layer formation through optimized laser spot(55μm)and powder sizes(1-5μm).Controlled cooling produces primary Si particles ranging from 150 nm to 1μm.The resulting microstructure enhances electrochemical performance,particularly by tailoring the size of primary Si.The resultant porous Si-Cu anode,featuring uniformly distributed primary Si(200 nm)metallurgically bonded with Cu networks,exhibits an initial coulombic efficiency of 83% and a remarkable capacity retention of 80% after 300 cycles at 2 C.In-situ and ex-situ observations confirm the crucial role of anode architecture in performance enhancement.This study elucidates the influence of the LPBF microstructure on anode performance and broadens the potential application of laser powder bed fusion in battery manufacturing.
基金supported by the National Natural Science Foundation of China(Nos.U2030206,12104022,52271014 and 22075003)the Presidential Foundation of CAEP(No.YZJJZL2023173)Sichuan Science and Technology Program(No.2021YFH0092).
文摘Li/MnO_(2) primary batteries are widely used in industry for their high specific capacity and safety.However,a deep comprehension of the Li^(+)insertion mechanism and the high self-discharge rate of the batteries is still needed.Here,the storage mechanism of Li^(+)in the tunnel structure of MnO_(2) as well as the dissolution and migration of Mn-ions were investigated based on multi-scale approaches.The Li/Mn ratio(at%)is determined at about 0.82 when the discharge voltage decreases to 2 V.The limited Li-ions transport rate in the bulk MnO_(2) restrains the reduction reaction,resulting in a low practical specific capacity.Moreover,utilizing spherical aberration-corrected transmission electron microscopy(TEM)coupled with electron energy loss spectroscopy(EELS),the presence of a mixed valence state layer of Mn^(2+)/Mn^(3+)/Mn^(4+)on the surface of the original 20 nm MnO_(2) particles was identified,which could contribute to the initial dissolution of Mn-ions.The battery separator exhibited channels for Mn-ions migration and diffusion and aggregated Mn particles.We put forward the discharge and degradation route in the ways of Mn-ions trajectories,and our findings provide a deep understanding of the high self-discharge rates and the capacity decay of Li-Mn primary batteries.
文摘BACKGROUND Glaucoma,a condition frequently linked to severe depression,anxiety,and sleep disturbances,affects treatment adherence while potentially compromising effectiveness.AIM To explore illness uncertainty(IU),anxiety,and depressive symptoms in primary glaucoma and to discuss underlying triggers.METHODS We recruited 120 primary glaucoma cases between January 2022 and November 2023.The Mishel Uncertainty in Illness Scale(MUIS)and the Hospital Anxiety and Depression Scale(HADS)[include HADS-anxiety subscale(HADS-A)and HADS-depression subscale(HADS-D)]subscales,were used to assess IU and emotional distress(anxiety/depression),respectively.The MUIS-HADS subscale interrelationships were determined by Pearson correlation.IU-associated determinants were identified using univariate and binary logistic regression analyses.RESULTS The cohort showed a mean MUIS score of 79.73±8.97,corresponding to a moderately high IU level.The HADS-A and HADS-D scores averaged 6.57±3.89 and 7.08±5.05 points,respectively,with 15.00%of participants showing anxiety symptoms and 24.17%exhibiting depressive signs.Significant positive connections were observed between MUIS and both HADS-A(r=0.359,P<0.001)and HADSD(r=0.426,P<0.001).Univariate analysis revealed that disease duration,insomnia,monthly household income per capita,and the presence of comorbid chronic conditions were significantly associated with anxiety or depression.Multivariate analysis identified insomnia as a risk factor and higher monthly household income as a protective factor.CONCLUSION Patients with primary glaucoma experience moderate IU levels,generally low anxiety,and mild depression.Specifically,the anxiety and depression risks were 15.00%and 24.17%,respectively.A significant positive correlation existed between IU and anxiety/depression in these patients.Additionally,insomnia or lower monthly household income elevated anxiety/depression risks,enabling reliable anxiety/depression risk categorization among patients.
文摘In China's healthcare system,primary healthcare services are crucial and bear the responsibility of safeguarding public health.However,at present,primary healthcare is facing many challenges,such as the scarcity of advanced medical equipment and insufficient provision of common basic examination instruments,which limits diagnosis.At the same time,a large number of professional talents have been lost,and the service level is difficult to meet the needs of the public.The public's trust in primary healthcare has decreased,exacerbating the mismatch of medical resources.The development of information technology has brought about telemedicine,which has become a key breakthrough.It uses Internet and other technologies to break regional restrictions,so that grass-roots patients can easily access expert diagnosis and treatment,and also provides a learning platform for grass-roots medical personnel.Thoroughly studying its application strategies is of great significance for improving the level of primary healthcare and promoting medical equity.
基金supported by the Noncommunicable Chronic Diseases-National Science and Technology Major Project(No.2023ZD0501400)National Key Research and Development Program of China(No.2023YFA1800204)+2 种基金Beijing Natural Science Foundation(No.L234036)Beijing Tongzhou District Science and Technology Project(No.KJ2024CX066)Peking University People’s Hospital Scientific Research Development Funds(No.RDJP2024-20)。
文摘Objective:Advanced gastric cancer remains highly refractory to therapy,with limited immunotherapy efficacy due to tumor microenvironment heterogeneity.Primary cilia,microtubule-based organelles involved in tumor progression,remain insufficiently explored in gastric cancer.This study aimed to define primary cilia subtypes and establish prognostic signatures for personalized treatment strategies.Methods:Bulk transcriptomic data from over 1,500 gastric cancer samples were integrated to define distinct primary cilia subtypes.A primary ciliary phenotype-associated signature(PCS)was established using a multimachine learning survival framework incorporating ten algorithms.The prognostic predictive value and immunotherapy response prediction capability of PCS were validated across multiple independent cohorts.Singlecell RNA sequencing analysis was performed to identify cellular populations associated with high-PCS phenotype.Causal weighted gene co-expression network analysis(WGCNA)was employed to identify driving factors,followed by functional validation through cell culture experiments and xenograft models.Results:Two distinct primary cilia subtypes were identified and validated across all cohorts,with C2 patients exhibiting significantly worse overall survival compared to C1 patients.PCS demonstrated robust predictive value for both prognosis and immunotherapy response,with superior accuracy compared to existing models across multiple validation cohorts.High-PCS patients showed reduced tumor purity,increased stromal cell infiltration,and poor response to immunotherapy.Single-cell analysis revealed that fibroblasts had the highest PCS scores and identified a novel secreted modular calcium-binding protein 2(SMOC2)^(high)myofibroblastic cancer-associated fibroblast(mCAF)population as the key driver of high-PCS phenotype.Functional experiments confirmed that SMOC2 knockdown significantly suppressed gastric cancer cell proliferation,migration,and invasion,while promoting mCAF-to-inflammatory cancer-associated fibroblasts(iCAF)transition.Conclusions:PCS serves as a robust prognostic biomarker for gastric cancer patients.Additionally,targeting SMOC2^(high)mCAFs represents a potential therapeutic strategy for patients with high-PCS gastric cancer.
基金funded by the National Key Research and Development Program of China(Grant No.2020YFA0608103)the National Science Foundation of China(Grant Nos.42265012 and 31770765).
文摘Enhancing the carbon sink of terrestrial ecosystems is an essential nature-based solution to mitigate global warming and achieve the target of carbon neutrality.Over recent decades,China has launched a series of long-running and large-scale ambitious forestation projects.However,there is still a lack of year-to-year evaluation on the effects of afforestation on carbon sequestration.Satellite remote sensing provides continuous observations of vegetation dynamics and land use and land cover change,is becoming a practical tool to evaluate the changes of vegetation productivity driven by afforestation.Here,a spatially-explicit analysis was conducted by combining Moderate Resolution Imaging Spectroradiometer(MODIS)land cover and three up-to-date remote sensing gross primary productivity(GPP)datasets of China.The results showed that the generated afforestation maps have similar spatial distribution with the national forest inventory data at the provincial level.The accumulative areas of afforestation were 3.02×10^(5)km^(2)in China from 2002 to 2018,it was mainly distributed in Southwest(SW),South(Sou),Southeast(SE)and Northeast(NE)of China.Among them,SW possesses the largest afforestation sub-region,with an area of 9.38×10^(4)km^(2),accounting for 31.06%of the total.There were divergent trends of affores-tation area among different sub-regions.The southern sub-regions showed increasing trends,while the northern sub-regions showed decreasing trends.In keeping with these,the center of annual afforestation moved to the south after 2009.The southern sub-regions were the majority of the cumula-tive GPP,accounting for nearly 70%of the total.The GPP of new afforestation showed an increasing trend from 2002 to 2018,and the increasing rate was higher than existing forests.After afforestation,the GPP change of afforestation was higher than adjacent non-forest over the same period.Our work provides new evidence that afforestation of China has enhanced the carbon assimilation and will deepen our understanding of dynamics of carbon sequestration driven by afforestation.
文摘BACKGROUND Primary cardiac lymphoma(PCL)is a rare subset of cardiac tumors,often diagnosed late due to nonspecific symptoms.It predominantly affects immunocompromised individuals,primarily in the pericardium and right heart.Late diagnosis mimics common cardiac ailments,leading to poor prognosis.AIM To systematically review the efficacy of rituximab in treating PCL either alone or in various chemotherapeutic regimens.Secondary objectives include evaluating morphological subtypes,assessing treatment regimens,and analyzing outcomes focusing on remission and adverse events.METHODS Following PRISMA guidelines,a comprehensive literature search was conducted across multiple databases,including PubMed,Hinari,Web of Science,and Scopus.English-language studies reporting the use of rituximab in treating PCL in humans were included.Study selection involved initial screening of titles and abstracts followed by full-text examination and data extraction.RESULTS Thirty-three case reports involving 36 patients were included in this systematic review.Diffuse large B-cell lymphoma was the predominant morphological subtype observed.The rituximab,cyclophosphamide,doxorubicin,oncovin,and prednisolone regimen emerged as the most commonly employed treatment strategy,indicating widespread acceptance and efficacy in PCL management.Combination therapies,including surgical intervention,showed promise in achieving complete remission,while some studies reported mortality despite aggressive treatment approaches.CONCLUSION Rituximab,particularly in combination with chemotherapy regimens,represents a significant advancement in PCL management,offering hope for improved patient outcomes.However,challenges such as variable treatment responses and adverse events underscore the complexity of managing PCL.Further research is warranted to refine therapeutic strategies and enhance diagnostic approaches for this rare cardiac malignancy.
基金Supported by the National Key Research and Development Program of China,No.2019YFC0840704Beijing Municipal Science and Technology Program,No.Z201100005520047.
文摘BACKGROUND Ursodeoxycholic acid(UDCA)is the first-line therapeutic agent for primary biliary cholangitis(PBC).However,a subset of patients exhibit a suboptimal response to UDCA,and reliable predictive biomarkers remain elusive.Studies have implicated plasma microRNAs(miRNAs)in the pathophysiological pro-gression of PBC,with certain miRNAs demonstrating potential as diagnostic and disease progression biomarkers.However,biomarkers capable of predicting the therapeutic efficacy of UDCA have not yet been identified.AIM To investigate differentially expressed miRNAs in PBC patients with divergent UDCA treatment responses and to explore potential biomarkers that predict treatment response in PBC.METHODS Plasma samples from treatment-naive PBC patients receiving≥1 year of standard UDCA treatment were collected.Efficacy was evaluated using the Paris I criteria.Patient samples were divided into discovery group(n=10)and validation group(n=30),with further stratification of patients into drug-resistant and drug-sensitive(DS)cohorts.Next-generation sequencing and quantitative real-time polymerase chain reaction were used to screen,functionally analyze,and validate the pre-treatment miRNA profiles of the treatment groups.RESULTS Forty-nine miRNAs were differentially expressed between the two groups before UDCA treatment(N=40).MiR-22-5p and miR-126-3p were highly expressed in the DS group before treatment(P<0.001),whereas miR-7706 exhibited a low expression(P=0.017).Post-treatment,miR-126-3p maintained low expression in the drug-resistant group(P=0.003),but showed elevated levels in the DS group(P<0.001).Logistic regression analysis identified miR-126-3p expression(odds ratio=34.32,95%confidence interval:1.95-605.40,P=0.016)as a significant factor influencing UDCA treatment response,while miR-22-5p(P=0.990)and miR-7706(P=0.157)showed no significant association.MiR-126-3p levels were negatively correlated with total bilirubin(r=-0.356,P=0.005)and immuno-globulin G levels(r=-0.311,P=0.015).The area under the receiver operating characteristic curve was 0.891(P=0.0003,95%confidence interval:0.772-1.000)with a sensitivity of 82.4%and a specificity of 84.6%.CONCLUSION Plasma miRNA expression profiles are heterogenous in patients with PBC with differential responses to UDCA therapy.MiR-126-3p demonstrates predictive potential for a suboptimal response to UDCA in patients with PBC.
文摘Casein kinase 1(CK1)is an important member of the serine/threonine protein kinase family,playing a crucial role in various cellular processes,including cell cycle regulation,signal transduction,DNA repair,and circadian rhythm control.CK1 is also essential in the nervous system,where it regulates neuronal growth,differentiation,and synaptic plasticity.Studies have shown that CK1δ phosphorylates neuron-specific proteins to regulate axonal growth and synaptogenesis.Primary cilia are non-motile microtubule structures present on the surface of most mammalian cells.Recent studies have revealed their multiple roles in cellular physiology and development,and dysfunction of cilia can impact the development and function of the nervous system.CK1 has an important role in the formation and function of primary cilia.By regulating various signaling pathways and the phosphorylation status of proteins,CK1 affects the generation,maintenance,and signaling transduction of cilia.In this review,the relationship between CK1,primary cilia,and the nervous system was explored,focusing on how CK1 influences cilia to regulate the structure and function of the nervous system.
基金supported by the Science and Technology Planning Project of Guangdong Province(2023A1111120011)the Natural Science Foundation of Guangdong Province(2024A1515010801).
文摘Objective:To investigate the lifestyle and myopia among primary school students in urban areas of Fujian with the context of myopia prevention and control measures,aiming to provide scientific evidence for identifying high-risk myopia population and formulating effective intervention strategies.Methods:A cross-sectional study was conducted from October to November 2023,enrolling 811 fourth-grade students from three primary schools in three cities across Fujian.Personal information and lifestyle-related pattern were collected using customized questionnaire.Participants underwent comprehensive ophthalmic assessments including distance visual acuity tests and refractive examinations.Logistic regression analysis was used to assess the impact of lifestyle on the onset of myopia.Results:The prevalence of myopia among fourth-grade students in urban primary schools in Fujian was 46.4%.Only 25.8%students engaged in outdoor activities for more than 2 hours daily,while63.3%participated in outdoor activities during class breaks.Multivariate Logistic regression analysis revealed that outdoor activities during class breaks(OR=0.646(95%confidence interval(CI):0.473-0.881),P=0.006)and daily time spent outdoors(2-3 hours,OR=0.682(95%CI:0.466-0.993),P=0.047;more than 3 hours,OR=0.403(95%CI:0.192-0.796),P=0.01)were independent protective factors against myopia.Lifestyle significantly enhanced the predictive performance for myopia(P=0.01).Additionally,parental myopia(one parent with myopia,OR=2.247(95%CI:1.612-3.145),P<0.001;both parents with myopia,OR=4.824(95%CI:3.262-7.204),P<0.001)emerged as a key risk factor for myopia.Conclusions:There is considerable scope for improving the lifestyle of primary school students in urban areas of Fujian.Lifestyle is strongly associated with myopia onset,highlighting the need for schools and families to actively encourage students to engage in more outdoor activities and take breaks outdoors to prevent and control myopia.Students with parents,especially both parents,having myopia should be considered as a key target group for myopia prevention efforts.
基金Supported by the National Natural Science Foundation of China(No.62020106015)the Beijing Municipal Public Welfare Development and Reform Pilot Project for Medical Research Institutes(No.PWD&RPP-MRI,JYY2023-6).
文摘AIM:To compare surgical efficacy based on residual peripheral anterior synechiae(PAS)extent af ter viscogonioplasty(VGP)combined with phacoemulsification and intraocular lens implantation(PEI)in patients with primary angle-closure disease(PACD)and identify risk factors for extensive postoperative PAS.METHODS:This prospective cohort study included 73 eyes of 61 patients with PACD undergoing PEI with VGP.Patients were divided into Group A(PAS<90°,n=39)and Group B(90°≤PAS≤180°,n=34)based on PAS extent at the end of surgery.PAS progression rates were assessed using a linear mixed-effects model.Logistic regression analyzed risk factors for PAS≥180°at 12mo postoperatively.RESULTS:Both groups showed significant PAS progression at 12mo(P<0.001).Group A had smaller PAS extent than Group B at all time points(P<0.001).PAS progression rates were similar between groups(P=0.335).No significant differences were found in intraocular pressure(IOP),IOP-lowering medications,or surgical success rates(P>0.05).Female[odds ratio(OR)=0.211,P=0.046],preoperative medication number(OR=1.017,P=0.029),and PAS extent at the end of surgery(OR=1.017,P=0.018)were risk factors for PAS≥180°at 12mo.CONCLUSION:Residual PAS extent at the end of surgery predicts postoperative extensive PAS formation but has limited effect on PAS progression rate and IOP control.Female,multiple preoperative IOP-lowering medications,and larger residual PAS extent are independent risk factors for extensive PAS at 12mo postoperatively.
文摘Primary biliary cholangitis(PBC)is a chronic cholestatic liver disease characterized by damage and loss of the epithelial lining of small intrahepatic bile ducts,leading to ductopenia and cholestasis.In advanced stages,this process results in cirrhosis and liver failure.The disease belongs to cholangiopathies.The review addressed historical questions concerning:The history of the first mention of this disease;how its nomenclature was formed;when specific serological tests were discovered and their importance in the diagnosis of PBC;the history of ursodeoxycholic and other bile acids for the treatment of PBC;and the significance of modern data on impaired bicarbonate production by cholangiocytes in the pathogenesis of PBC.
